Background: Contemporary recommendations for primary and revision ankle arthrodesis favor internal compression techniques involving the use of screw and/or plate fixation. While tibiotalocalcaneal arthrodesis with internal fixation may be a suitable method of salvage for the treatment of a failed tibiotalar arthrodesis in selected patients, ring external fixation has been reported as an alternative. We reviewed our experience with revision tibiotalar arthrodesis, with a focus on ring external fixation. Methods: Forty-five consecutive patients underwent revision tibiotalar arthrodesis with use of repeat internal fixation (eleven patients), ring external fixation (twenty-two patients), or tibiotalocalcaneal arthrodesis (twelve patients). Union rates were assessed radiographically, and functional outcome was determined with use of preoperative and postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot scores. Results: All forty-five patients were available for follow-up at an average of 50.3 months. The average ankle-hindfoot score improved from 31.1 points preoperatively to 65.8 points at the time of the most recent follow-up. At the time of the most recent follow-up, the union rate was 88.9% (forty of forty-five). Fusion was achieved with revision tibiotalar arthrodesis in thirty-six (80%) of forty-five patients, including eight of the eleven patients in the repeat internal fixation group, nineteen of the twenty-two patients in the ring external fixation group, and nine of the twelve patients in the tibiotalocalcaneal arthrodesis group. Re-revision led to union in four of five patients. The overall union rate for ring external fixation, including revision and re-revision tibiotalar arthrodeses, was 84.6% (twenty-two of twenty-six). The five patients with persistent nonunion following revision ankle arthrodesis opted for transtibial amputation. Conclusions: Revision tibiotalar arthrodesis leads to satisfactory limb salvage in a majority of patients. Ring external fixation may facilitate clinically acceptable limb salvage in complex cases when methods of internal fixation are limited or even contraindicated. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Background: The accuracy of reduction of distal tibiofibular syndesmosis disruptions has been associated with the clinical outcome. Suture-button fixation of the syndesmosis is a dynamic alternative mode of fixation. We hypothesized that with deliberate clamp-induced malreduction, suture-button...

Purpose: Spondylolisthesis surgical treatment is often difficult with higher degree of slip and related techniques still debated. We have taken into consideration double thread recoil Schanz screws. This system should allow the best reduction of the slip, treating only the affected vertebrae....

Biomechanics: The biomechanical concept of compression nailing consists of the use of an intramedullary device that is inserted into the medullary cavity without jamming and that allows a relative movement of the fragments after locking. First, the implant is firmly attached to the distal main...

Introduction: Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure. Methods: We investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail...

Background: Conversion of ankle arthrodesis to total ankle arthroplasty remains controversial. Although satisfactory outcomes have been published, not all foot and ankle surgeons performing total ankle arthroplasty have embraced this modality.Methods: Twenty-three total...

Fracture fixation in severe osteoporotic bone by means of implants that rely on screw anchorage is still a clinical problem. So far, a sufficiently accurate prediction of the holding capacity of screws as a function of local bone morphology has not been obtained. In this study the ultimate...

Introduction: Osteoporotic fractures of the distal femur (primary as well as periprosthetic) are a growing problem in todayâ€™s trauma and orthopaedic surgery. Therefore, this feasibility study should identify the biomechanical potential of a (commercially available) spiral blade in the...

The article offers information on the orthopedic fixature Intramedullary Nails for extracapsular hip fracture. It mentions that extramedullary sliding hip screws were the standard of care from the 1950 to the 1990, but many surgeons now prefer intramedullary nails that interlock proximally in...